DESCRIPTION: The overarching aim of the current application is to support the ability of the Mid-Atlantic Node to continue its participation in and enhance the scientific research mission of the NIDA Drug Abuse Treatment Clinical Trials Network (CTN) as the mission of the CTN continues to evolve. Our leadership of and participation in CTN research has been substantial and forms the basis for continued contributions. In the most recent funding period, we participated successfully in three CTN studies (0032, HIV Rapid Testing and Counseling; 0044, Web-Based Treatment of Substance Abusers; 0049, Hospital as the Opportunity for Patient Engagement), conducted two ancillary studies and enrolled over 600 participants. Currently, we are participating in two studies (0051; 0059) and providing national leadership for CTN 0059, a study to develop and validate a substance use screening and assessment tool for use in future CTN research. Our faculty offers expertise in a wide range of research areas including behavioral and pharmacological treatment of substance abuse, treatment of adolescents with substance use disorders, medications development, contingency management, screening, assessment and brief intervention, HIV treatment, tobacco smoking treatment, clinical trials methodology and qualitative research. We propose to continue supporting our well-established Node infrastructure that is needed to carry out the CTN research mission and to continue contributing the expertise and leadership available within the node. We envision and propose an innovative CTN research agenda with high public health importance that will identify and intervene with substance users found within medical care settings. New research on Screening and Brief Intervention will seek to identify subgroups that may benefit from this approach. Other proposed research will focus on linkage of patients with substance use at levels requiring more intensive intervention to treatment services. Patient Navigation will be examined as an approach to facilitating the care transitions across service delivery systems and motivating patients to engage in available services. This agenda builds on past CTN research and provides a visionary and feasible blueprint for cooperative multi-site research within the CTN and its affiliated medical care and drug treatment institutions. We have long maintained strong affiliations with an array of adult and adolescent community substance abuse treatment programs. Recent developments in health care have expanded the focus of our community involvement increasingly toward medical settings, including those with comprehensive care models that deliver both primary care and behavioral health services. We will continue to affiliate and engage a variety of hospital, community health and substance abuse treatment agencies that will serve as future resources for recruitment and conduct of CTN research. Overall, the Mid-Atlantic Node has made substantive contributions to the CTN that provide the foundation for its future involvement, and is well positioned to continue this involvement.